Doing the NESP programme gave Wendy Montgomery the skills, learning and confidence to develop a number of new projects at her service that have been of great benefit to service users.
Wendy works at Pathways in Auckland. With several branches around the country, Pathways is the largest NGO mental health service provider in New Zealand. Where Wendy works there are six beds and the average stay for service users is four to seven days.
After completing her nursing degree in 2008 she took a job as a practice nurse with a general practitioner. Her plan was always to move into mental health nursing, but she thought it important to learn about people’s physical health first because “so many mental health service users also have significant physical health issues”.
In 2013 she applied or a job at Pathways because she liked the ethos of the NGO and because she wanted to work in the community rather than in a hospital setting. Her role there is as a registered health professional. It’s not a specified nurse role, but she uses her nursing skills alongside other support workers.
She works with a range of service users. Most have acute needs and are quite unwell with problems like depression, anxiety, schizophrenia, psychosis, bipolar disorder or suicidal thoughts. Her role is to support them according to their individualised needs. She uses strength-based methods to improve both their mental and physical wellbeing and always tries to be holistic in her approach to wellness.
In 2015 Wendy decided to enrol in the NESP programme because she wanted her Post-Graduate Certificate in Mental Health and Addiction. She also liked the idea of further study and developing her skills so she could branch out a little, build on her portfolio and increase her professional development hours.
Challenges and support
There are no other trained nurses where Wendy works so the most significant challenge arising from the study was a feeling of isolation. She felt she didn’t have the advantages many district health board nurses have in terms of ready support from colleagues and senior nurses.
Related to this, it was very difficult for her to find a supervisor. NESP students are required to meet with a supervisor 10 times per semester but this was waived for Wendy because of her circumstances. However, a supervisor was found for her by Pathways’ Service Relations Manager Ines Bruin once she had finished her studies.
Sometimes the intensity of the study was a struggle in terms of time, but Wendy says Pathways staff were very supportive. They gave her a paid day off to attend courses each fortnight and were understanding and supportive when they knew she had a heavy study load.
Benefits to service users
“I loved how the course was so recovery-focused,” Wendy says.
“I had been working in the sector for some time, so nothing in the study was completely new, but it did build on and consolidate my existing knowledge.”
Sensory modulation is one example. This had always been of interest to Wendy but covering it during the NESP study set her on a pathway to learn even more. She did some other courses, researched some recent papers on sensory modulation in acute inpatient settings and began purchasing the necessary equipment so it could be incorporated into the service at Pathways Auckland.
I loved how the course was so recovery-focused.
She started with a questionnaire to help identify people’s triggers, what helps or hinders them. “Then it’s a matter of working with them to find what helps them find calmness. It’s very individualised and I’ve worked out procedures for taking service users through the steps needed to find what benefits them. It’s working really well.”
Wendy also worked on the service’s note-writing programme which, she says, didn’t have enough of a set format or structure.
“The first thing you learn in mental health nursing is how to do assessments, but this wasn’t built into the procedure. I’m still working on this initiative and on improving assessment skills so that when clinical teams come in we can tell them how a person is presenting or progressing. We weren’t really capturing that information as well as we could have been.”
She says NESP was really helpful in preparing her to take on these initiatives. “We did quite a lot around things like risk assessment and how to write mental state assessments. NESP has greatly increased my confidence and my ability to show leadership, so it’s really been of benefit to the whole team.”
Wendy particularly enjoyed the NESP training in mindfulness and this is also something she has introduced at Pathways. Again, she did some individual research and has now incorporated several mindfulness models into the service. She often uses guided mindfulness meditation, which is short and easy for all to participate in regardless of how much knowledge or experience they have.
One involves an app that focuses a person on their body from the toes upward in stages, so they can just be mindful of what’s going on for them physically. Wendy says service users are really benefiting from these and other mindfulness exercises.
“We have discussions afterwards about how they found it and whether it helped; and 99 percent say they thought it was really centring and grounding, or that it relieved their tension.
Why Wendy recommends NESP
Wendy says mental health training is only a focus for one semester during undergraduate training – with the rest of the training focusing on physical health. That’s why she believes NESP training is essential; especially for new graduates because it could really open them up to the world of mental health.
“The beauty of NESP is that it helps consolidate your learning and build on what you already know so you can bring new and better things to your practice.”